Percutaneous interventions in adults with complex cyanotic congenital heart disease

Adult patients with complex cyanotic heart disease present unique anatomic and physiological challenges. Changes in pulmonary blood flow over time may cause progressive cyanosis and exercise intolerance. The utility of percutaneous intervention in palliating adults with complex anatomy is unknown.

This is a single-center case series of percutaneous interventions in adults with complex cyanotic heart disease. Six patients (5 males, 1 female) underwent a total of 9 percutaneous interventions. Three patients required a second intervention 2, 10, and 13 months after the first intervention. Patients were followed a mean of 35 months after the first intervention.

Eight interventions were performed for diminished pulmonary blood flow and 1 intervention was performed for excessive pulmonary blood flow. Age at first intervention ranged from 28 to 48 years. Procedural success rate was 100%. There were no procedure-related complications. Mean oxygen saturation increased from 77% prior to the procedure to 86% after the intervention. All patients experienced symptomatic improvement. There was 1 late sudden death 17 months post procedure.

Percutaneous intervention can be performed safely and improves symptoms and oxygenation in adults with complex cyanotic heart disease.